29 Mar Pronounced State-level Variation in Distribution of Oxycodone and Opioid-related Deaths from 2000-2021
MedicalResearch.com Interview with:
Dr. Solgama
Jay P. Solgama
Medical Student
Department of Medical Education
Geisinger Commonwealth School of Medicine
Scranton PA
MedicalResearch.com: What is the background for this study?
Response: The opioid crisis in the United States continues to escalate, with opioid-related deaths increasing by over 800% since 2000. Prescription opioids, particularly oxycodone, have been a contributor to this crisis, with substantial variations in their distribution observed across different states [1,2,3].
Against this backdrop, the study conducted by researchers from the Geisinger Commonwealth School of Medicine aimed to characterize the distribution of oxycodone across US states from 2000 to 2021. By analyzing data from the Drug Enforcement Administration’s comprehensive Automation of Reports and Consolidated Orders System (ARCOS) and the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (WONDER) databases, the study sought to identify trends and patterns in oxycodone distribution and their potential implications for opioid-related deaths [4,5].
MedicalResearch.com: What are the main findings?
Response: The investigation [6] unveiled notable trends in oxycodone distribution across US states from 2000 to 2021. Total oxycodone distribution experienced a sharp increase of 280% from 2000 to its peak in 2010, followed by a gradual decline of 54% by 2021. Pharmacies emerged as the predominant distributors of oxycodone, responsible for over 94% of total distribution, with a pattern closely mirroring total distribution. Notable differences arose when distribution was grouped by business type, with hospitals and practitioners showing distinct distribution patterns.
State-level analysis revealed substantial variations in oxycodone distribution, with certain states consistently demonstrating elevated distribution levels compared to others. Florida, Delaware, and Tennessee stood out as states with consistently high oxycodone distribution over specific periods. Conversely, states like Texas and Illinois maintained comparatively lower distribution levels. There was a +800% increase in opioid-related deaths during the study period, with recent increases largely being driven by synthetic narcotics. There was a notable increase in heroin-related deaths as oxycodone distribution dropped after 2010.
MedicalResearch.com: What should readers take away from your report?
Response: This study [6] underscores the considerable interstate variability in oxycodone distribution across the United States and highlights the evolving nature of the opioid epidemic. While the findings reveal a general decline in oxycodone distribution since its peak around 2010, the factors driving these patterns are likely multifaceted. Variability in distribution patterns among pharmacies, hospitals, and practitioners suggests potential differences in prescribing practices and regulatory environments across healthcare settings. Furthermore, the observed disparities between states underscore the importance of investigating legislative policies, provider behaviors, patient expectations and other contextual factors that may contribute to these differences.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should investigate the factors driving differences in oxycodone distribution among states and healthcare settings. Longitudinal analyses tracking distribution changes alongside regulatory shifts could assess intervention effectiveness. Comparative studies between states may identify best practices to address the opioid crisis.
MedicalResearch.com: Is there anything else you would like to add?
Response: Researchers and policymakers can benefit from utilizing both the ARCOS database provided by the Drug Enforcement Administration and the CDC WONDER database, which offer valuable insights into opioid distribution and mortality patterns, respectively. Increased utilization of these resources can inform evidence-based strategies for opioid stewardship and help address the ongoing opioid crisis effectively.
Citations:
- Ighodaro EO, McCall KL, Chung DY, Nichols SD, Piper BJ. Dynamic changes in prescription opioids from 2006 to 2017 in Texas. PeerJ. 2019;7:e8108.
- Eufemio CM, Hagedorn JD, McCall KL, Piper BJ. An analysis of oxycodone and hydrocodone distribution trends in Delaware, Maryland, & Virginia between 2006-2014]. Cureus 15(4):e38211.
- Cabrera FF, Gamarra ER, Garcia TE, Littlejohn AD, Chinga PA, Pinentel-Morillo LD, et al. Opioid distribution trends (2006–2017) in the US Territories. PeerJ. 2019;7:e6272.
- S. Department of Justice Drug Enforcement Administration, Diversion Control Division. Data from: Automation of Reports and Consolidated Orders System. ARCOS Retail Drug Summary Reports, August 14, 2022. Accessed at https://www.deadiversion.usdoj.gov/arcos/retail_drug_summary/index.html.
- Centers for Disease Control and Prevention, National Center for Health Statistics. Data from: Multiple Cause of Death 1999 – 2020. CDC WONDER Database, February 25, 2024. Accessed at http://wonder.cdc.gov/mcd-icd10.html.
- Solgama JP, et al. Pronounced state-level variation in distribution of oxycodone and opioid-related deaths from 2000-2021. BMJ Open 2024-in press: https://pubmed-ncbi-nlm-nih-gov.gcsom.idm.oclc.org/38453203/
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Last Updated on April 1, 2024 by Marie Benz MD FAAD